Coronary heart disease is a disorder of the blood vessels of the heart which can lead to heart attacks. These occur when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart.

One of the key health differences between men and women is the fact that heart attacks are different in each sex. Heart disease accounts for a third of all deaths in women and having a stroke accounts for more deaths among women than men.

Perhaps the most worrying statistic is that 42% of women who have heart attacks die within 1 year, compared to 24% of men and under 50, women’s heart attacks are twice as likely as men’s to be fatal.

Since 1984, more women than men have died each year from heart disease and the gap between men and women’s survival continues to widen.

The 3 key differences in diagnosis and treatment

In men chest pain is usually the primary symptom, but 71% of women experience early warning signs of heart attack with sudden onset of extreme weakness that feels like the flu, often with no chest pain at all. This means that nearly two-thirds of the deaths from heart attacks in women occur among those who have no history of chest pain.

1. Plaque. One key difference lies in the fact that men’s plaque distributes in clumps whereas women’s distributes more evenly throughout artery walls. This results in blockage in men, leading to an attack, but women’s angiograms are often misinterpreted as “normal”.

2. Delay. Women wait longer than men to either go to their doctor or hospital when having a heart attack. Doctors are also slower to recognize the presence of heart attacks in women because “characteristic” patterns of chest pain and EKG changes are less frequently present.

3. Treatment. After a heart attack, women are less likely than men to receive treatment such as beta blockers, ACE inhibitors and aspirin – therapies known to improve survival. This contributes to a higher rate of complications after heart attacks in women, even after adjusting for age. Women who are eligible candidates to receive life-saving clot-buster drugs are far less likely than men to receive them according to US studies.

These factors combined mean that women are twice as likely as men to die within the first few weeks after suffering a heart attack and 38% of women, compared to 25% of men, will die within one year of a first recognized heart attack.

Risk factors for heart disease

Heart disease is a lifelong condition – once you get it, you’ll always have it and menopause increases the risk. Not just an age factor, but the likelihood of extra weight and oestrogen dominance also play their part.

So, it is vital to take action to prevent and control the disease, so it makes sense to assess regularly your own risk factors. These include:

• High blood pressure/high cholesterol
• Stress
• Diabetes and prediabetes
• Smoking
• Being overweight and/or or physically inactive
• History of irregular periods and/or early menopause
• Having a family history of early heart disease
• Having a history of preeclampsia during pregnancy
• Unhealthy diet

Each risk factor greatly increases a woman’s chance of developing heart disease. But having more than one risk factor is especially serious, because risk factors tend to ‘gang up’ and worsen each other’s effects.

How to reduce your risk

It is estimated that three in four women have at least one risk factor – but most are unaware of it. The good news is that women’s hearts respond better than men’s to healthy lifestyle changes, so prevention is definitely the best strategy.

At menopause tackling excess weight and oestrogen dominance is key. Progesterone is known to be protective of heart health so ensure your hormone levels are in balance and you do not have exposure to unopposed oestrogen from any source including HRT.

If you have any risk factors make sure you regularly monitor your blood pressure and cholesterol levels and follow a heart-healthy eating routine such as the Mediterranean Diet.

Losing weight and taking more exercise will help, but experts in the US agree that just focusing on weight loss is not enough and can be counterproductive. Just being told you have to lose weight discourages women from seeking help from their doctor when they are looking for a wider range of strategies to avoid heart disease.

Previous studies have shown that men are ‘significantly more likely’ to receive recommended heart monitoring, and less likely to be told to lose weight according to findings presented at the American College of Cardiology’s 65th Annual Scientific Session.